Frequently Asked Questions Regarding
Health Care and Medical
- How do I get medical information about an inmate?
- After Release from Prison:
- A completed DC4-711B, Consent and Authorization for Use and Disclosure Inspection and Release of Confidential Information, must be completed and signed by the inmate. By signing the DC4-711B, the inmate is authorizing release of medical, dental, or mental health information to a designated person/entity. By signing the release, the inmate(s) also understands that if the person or entity authorized to receive the health information is not a health-care provider, then the disclosed health information may no longer be protected from further disclosure by state or federal law.
- This form can be completed by the inmate's family member, healthcare provider, attorney, or any individual that the inmate consents to receive PHC information.
- The completed form must be mailed to:
Reception Medical Center
Attn: Medical Records
7765 S. CR 231
P.O. Box 628
Lake Butler, Fl 32054-0628
- While Incarcerated:
- The inmate must contact the medical department at their facility and request/complete a Release of Information form.